Op-ed: Adherence deserves historic collaboration

I took an opportunity at the 2009 NACDS Annual Meeting to reflect on words spoken 70 years earlier by then-NACDS president Nate Shapero of Cunningham Drug Stores. His words at the second annual convention of NACDS, on May 5, 1939, could have been delivered today: “At our first annual convention last year, I sounded the keynote of the ‘Triumph of Cooperation’ … our association … is an effective instrument for the elimination of the evils in our industry, and for the development of a sound relationship between the manufacturer … the producer … the chain store … and between ourselves and the public.”

If there is any doubt that there are challenges that need to be overcome, and that there is a need for collaboration, just consider the attacks that are levied against pharmacy and pharmaceutical suppliers. There are those who say that pharmacists perform only a dispensing function. About manufacturers, some remain fixated in their rhetoric on what they call the high price of prescription drugs, without any context related to research costs, the public benefit and the costs avoided by treatment of chronic disease.

It just may be that the concept of adherence is the bridge to greater understanding among policy-makers and the public of the dual value of pharmacy and pharmaceuticals. As this understanding increases, so will the appreciation of pharmacists, pharmacies and medications.

Medications are important to the management of chronic diseases that require long-term or lifelong therapy. Pharmacists are uniquely qualified as medication experts to work with patients to manage their medications and chronic conditions, and play a key role in helping patients take their medications as prescribed.

Nonadherence with medications is a significant problem. According to a report by the World Health Organization, in developed countries only 50% of patients with chronic diseases adhere to medication therapies. In the United States, failure to take medications as prescribed has been estimated to impose more than $177 billion dollars annually in direct and indirect costs. Poor adherence leads to unnecessary disease progression, reduced functional status, more extensive and more expensive medical care, a lower quality of life and premature death.

Studies have demonstrated that pharmacist-provided medication therapy management services can help. In one frequently cited study, every $1 invested in MTM services reduced overall healthcare costs by more than $12. We must spread the news about this opportunity to reduce healthcare costs, while improving patient care and quality of life.

This is why NACDS is working with allied organizations for enhancement of the MTM benefit in Medicare Part D. That also is why the NACDS Foundation is supporting educational initiatives, along with the Pharmaceutical Research and Manufacturers of America, that are designed to enhance the public understanding of factors affecting medication adherence.

Together, we must boost appreciation for the value that comes from proper utilization of prescription drugs. During the current healthcare reform debate, NACDS has a lot to offer as a retail association. We can make a personal and credible pitch for the overall benefits of the kinds of products and services for which suppliers are responsible. By definition, pharmacies and pharmacists are the segment of the supply chain that is closest to the people.

In last year’s Gallup survey that measured the public’s perception of professional integrity, pharmacists came in second, right behind nurses. Pharmacists have been in the top three each of the past six years. Our industry is blessed with ideal ambassadors for mutual issues of importance, which directly affect the well-being of patients and the entire healthcare system.

Nate Shapero was on to something when he spoke in 1939 about NACDS’ ability to leverage productive relationships. He did not live in Utopia any more than we do. He was a businessman — struggling with economic turmoil, competition, business relationships and responsibilities to view his world broadly, at the helm of an industry association. But these factors did not delay, derail or deny the vision and pursuit of a common purpose. That is a concept that must not be lost on us today.

On behalf of NACDS, we look forward to working with you, for the ultimate good of the patients we serve.

ALEXANDRIA, Va. Vindicating claims made over the last two years or more by the National Association of Chain Drug Stores and other pharmacy groups, the Department of Defense revealed that allowing the military to negotiate with drug manufacturers for lower prices on retail prescriptions is saving taxpayers big sums of money.

NACDS president and CEO Steven Anderson Thursday hailed the findings as a victory for community pharmacies — and for freedom of choice for military members and their families.

The Defense Department revealed that it will spend an estimated $1.67 billion less on prescription drug medications in the 2010 fiscal year than previously projected. Behind the cost savings: a change in the way the agency obtains drug supplies for prescriptions sold in community pharmacies to beneficiaries enrolled in the TRICARE military health program. That change became effective with the release of new DoD regulations in March that allow the military to obtain pricing discounts for prescriptions sold at retail.

Those discounts, generated through direct negotiations between federal procurement officials and pharmaceutical companies, are clearly lowering the costs for the TRICARE program — and for the military beneficiaries who fill prescriptions in local community pharmacies.

“This is a true victory for military service members and their families,” Anderson said. “A rule implemented earlier this year enabled the Department of Defense to obtain pricing discounts for retail prescription medications,” he added. “Those discounts will result in remarkable savings for the Department, which translates to pharmacy choice for TRICARE beneficiaries. Military families will maintain the option to obtain their prescriptions and other pharmacy services from a retail pharmacy.

Anderson cited “an ongoing, multi-year effort” by NACDS to preserve freedom of choice for military beneficiaries, and to prevent the government from discouraging those beneficiaries — via higher out-of-pocket costs — from obtaining their prescriptions at a retail pharmacy rather than through a mail order pharmacy or military base pharmacy. The pricing discounts had long been sought by the retail pharmacy industry as a way to level the playing field between retail and mail order pharmacies serving the more than 9 million military health beneficiaries enrolled in the federal program. Historically, retail pharmacies have operated at a competitive disadvantage vis-a-vis mail-order and military-base pharmacies, because prescription costs were higher for military members and their families if they chose to fill their scripts in a community pharmacy setting.

“The value of a pharmacist in counseling on adhering to medication regimens, preventing possible drug interactions and improving health outcomes is invaluable to all patients, and should not be limited for the brave men and women and their families who serve and sacrifice,” Anderson asserted.

Home Diagnostics, Inc. reports spike in retail sales

FORT LAUDERDALE, Fla. Home Diagnostics, Inc. on Thursday realized a 45.2% increase in retail channel sales for the second quarter ended June 30, the company announced.

Retail sales were driven by the continued national rollout of the TRUEresult and TRUE2go blood glucose monitoring systems and the expanded product portfolio at Walmart. Though total revenue for the second quarter was $32.7 million, a decrease of 2.1%. International sales decreased 22.3%, reflecting lower sales in Latin America following the company’s decision to limit its exposure in that region due to poor economic conditions.

“We are particularly pleased with our domestic sales which grew during the quarter, outpacing the reported results of the majority of our branded competitors, which reported sales declines for the quarter,” stated Joseph Capper, president and CEO of HDI. “This reflects our position as a leading provider of value-priced, high-quality blood glucose monitoring products. We achieved 45% growth in our retail channel, driven by strong reception of our new products, TRUEresult and TRUE2go, as well as organic growth of existing products with our major retail partners.”

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